1. Karin Hannes Centre for Methodology of Educational Research K.U.Leuven

3.  The more you appraise, the more it stifles creativity. The main criterion is relevance !  The more you appraise, the lesser the chance to end up with flawed results. The main criterion is quality !

4.  That’s no longer the question… I appraise!  The question is…

5. Which criteria am I going to use when evaluating methodological quality?

6.  MAKING SENSE OF THE MYRIAD OF CRITICAL APPRAISAL INSTRUMENTS

7.  Selection of appraisal instruments: › Used in recently published QES (2005-2008) › Online available and ready to use › Broadly applicable to different qualitative research designs › Developed and supported by an organisation/institute/consortium or a context other than individual, academic interest.

8.  Three instruments fit the inclusion criteria: › Joanna Briggs Institute-Tool http://www.joannabriggs.edu.au/cqrmg/tools_3.html › Critical Appraisal Skills Programme-Tool http://www.phru.nhs.uk/Doc_Links/Qualitative%20Appraisal%20To ol.pdf › Evaluation Tool for Qualitative Studies http://www.fhsc.salford.ac.uk/hcprdu/tools/qualitative.htm  To facilitate comparison: › Criteria grouped under 11 headings › Cross-comparison of the criteria (main headings)

10. CriterionJBICASPETQS Screening QDetails study Theoretical frameworkNO Appropriateness designNO Data collection procedure Data-analysis procedure Findings ContextNO Impact of investigator BelievabilityNO Ethics Evaluation/OutcomeNO Value/Implication ResearchNO

11. CriterionJBICASPETQS Screening QDetails study Theoretical frameworkNO Appropriateness designNO Data collection procedure Data-analysis procedure Findings ContextNO Impact of investigator BelievabilityNO Ethics Evaluation/OutcomeNO Value/Implication ResearchNO All 3 instruments have focussed on the accuracy of the audit trail = Quality of reporting.

12. Let’s change the focus from  What had been evaluated in critical appraisal instruments? To  What should be the main focus in evaluating the methodological quality in qualitative research.

13.  Validity and researcher bias should be evaluated  Some Qual. studies are more rigorous than others.  Epistemological and ontological assumptions of Quant. and Qual. research are incompatible  It is inappropriate to use such measures. Validity in Quant. Research  instruments and procedures Validity in Qual. Research  kinds of understanding we have of the phenomena under study (accounts identified by researchers)

14.  We need to know › whether the set of arguments or the conclusion derived from a study necessarily follows from the premises. › whether it is well grounded in logic or truth. › whether it accurately reflects the concepts, the ideas that it is intended to measure. What is validity?  operationalisation using Maxwell’s framework

15.  Maxwell’s deconstruction of the concept validity (1992) › Descriptive validity › Interpretative validity › Theoretical validity › Generalisibility (external validity) › Evaluative validity

16.  The degree to which descriptive information such as events, subjects, setting, time, place are accurately reported (facts rather than interpretation).  Evaluation techniques: Methods- & Investigator triangulation  allows for cross-checking of observations

17.  The degree to which participants’ viewpoints, thoughts, intentions, and experiences are accurately understood and reported by the researcher.  Evaluation techniques: Display of citations, excerpts, use of multiple analysts (inter-rater agreements), self- reflection of the researcher, (member checking).

18.  The degree to which a theory or theoretical explanation informing or developed from a research study fits the data and is therefore credible/defensible.  Evaluation techniques: Persistent observation  stable patterns, deviant or disconfirming cases, multiple working hypotheses, theory triangulation and active search for deviant cases, pattern matching

19.  The degree to which findings can be extended to other persons, times or settings than those directly studied.  Evaluation techniques: Demographics, contextual background information, thick description, replication logic

20.  The degree to which a certain phenomenon under study is legitimate, degree to which an evaluative critic is applied to the object of study.  Evaluation techniques: Application of an evaluative framework, ethics,...

22.  The most commonly used instrument ‘CASP’, is the least sensitive to aspects of validity (findings based on screening the main headings). It does not address interpretive nor theoretical validity or context as a criterion. › The theoretical position and the background of a researcher has a direct impact on the interpretation of the findings. › Statements that have no clear link to excerpts are at risk of not being grounded in the data. › Therefore, they should be LEAD CRITERIA in a critical appraisal instrument!

23.  This study is limited by › Its focus on the main headings of the instrument. Some of the subheadings of CASP do address issues of e.g. interpretive validity and some issues are not addressed in the JBI-tool, e.g. sampling procedures. › its focus on validity as an evaluation criterion. Which other aspects are important to consider in evaluating the quality of an instrument?

24.  Are there fundamental differences between appraisal instruments?  Do we need to give our choice of appraisal instrument some thought?  Could it assist us in evaluating the (methodological) quality of a study?  Does it help us to establish rigor in qualitative research?

25.  Checklists only capture what has been reported.  I argue for the use of verification techniques for validity as a means for obtaining rigor.  In evaluating validity at the end of a study (post hoc), rather than focusing on processes of verification during the study we run the risk of missing serious threats to validity until it is too late to correct them.

26.  Basic qualitative researchers › should be motivated to adopt techniques that improve validity › Should be guided in how to report qualitative research in order to facilitate critical appraisal

27.  The development of a standards set of reporting criteria for qualitative research is virtually impossible!  The development of a standard set of reporting criteria would facilitate critical appraisal. We might need you! To participate in a Delphi study on exploring the potential feasibility, appropriateness, meaningfulness and effectiveness of reporting criteria.

28.  To validate is to investigate, to check, to question, and to theorize. All of these activities are integral components of qualitative inquiry that insure rigor (Morse, 2002).  The process of inquiry is where the real verification happens.